Whereas the total number of new medicines approved by the US Food and Drug Administration inched up only a hair's breadth last year—from 25 in 2008 to 26 in 2009—the agency gave the green light to more first-of-its-kind therapeutic biologics than ever. Could 2009 have been the year when biotech drugs started to take over from the small-molecule field? “It is too soon to declare a breakthrough, but this is the direction medicine has been heading for some time, and perhaps the momentum is picking up,” Ira Loss, a senior healthcare analyst at the research firm Washington Analysis, told Nature Medicine. “Let's see what happens in 2010.”